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Comparison of the efficacy of different protocols of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function, activities of daily living, and neurological function in patients with early stroke: a systematic review and network meta-analysis.

作者信息

Ni Xueyi, Yuan Zinan, Xie Ruimou, Zhai Xiaoxue, Cheng Xiang, Pan Yu

机构信息

Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, Beijing, 102218, China.

出版信息

Neurol Sci. 2025 Jun;46(6):2479-2498. doi: 10.1007/s10072-025-08000-5. Epub 2025 Feb 5.


DOI:10.1007/s10072-025-08000-5
PMID:39910020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12084249/
Abstract

BACKGROUND: The application of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in patients with early stroke has recently received considerable attention, but the optimal protocol remains inconclusive. This study intends to evaluate and compare the effects of different protocols of tDCS and rTMS on improving motor function, activities of daily living (ADL), and neurological function in patients with early stroke, and to comprehensively assess their efficacy and safety. METHODS: MEDLINE, Embase, Cochrane Library, and Web of Science were searched. Risk of bias (RoB) was assessed using the Cochrane Risk of Bias 2.0 tool, and Bayesian NMA was conducted using R4.3.1 and Stata16. RESULTS: The results of NMA showed that after early intervention, bilateral application of high- and low-frequency rTMS (BL-rTMS) performed best in improving the upper extremity motor function at the end of intervention (SUCRA: 92.8%) and 3 months (SUCRA: 95.4%). Besides, low-frequency rTMS (LF-rTMS) performed best in improving the lower extremity motor function (SUCRA: 67.7%). BL-rTMS was the most effective in ameliorating the ADL at the end of intervention (SUCRA: 100%) and 3 months (SUCRA: 85.6%). In terms of the NIHSS scores, BL-rTMS had the highest probability of being the most effective measure at the end of intervention (SUCRA: 99.7%) and 3 months (SUCRA: 97.05%). Besides, LF-rTMS (0%), 5 Hz-rTMS (0%), and intermittent theta-burst stimulation (iTBS) (0%) all exhibited a good safety profile. CONCLUSION: BL-rTMS is the optimal stimulation protocol for improving upper extremity motor function, ADL, and neurological function in early stroke, with long-term efficacy.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/c9bb2cb76a30/10072_2025_8000_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/38809848a053/10072_2025_8000_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/fd8987eadcda/10072_2025_8000_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/9f0034250a45/10072_2025_8000_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/fe7f0ed72df5/10072_2025_8000_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/f1e82dac03aa/10072_2025_8000_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/b094ac99ac29/10072_2025_8000_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/024e33d5ac56/10072_2025_8000_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/257e6c92c9b5/10072_2025_8000_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/c9bb2cb76a30/10072_2025_8000_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/38809848a053/10072_2025_8000_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/fd8987eadcda/10072_2025_8000_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/9f0034250a45/10072_2025_8000_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/fe7f0ed72df5/10072_2025_8000_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/f1e82dac03aa/10072_2025_8000_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/b094ac99ac29/10072_2025_8000_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/024e33d5ac56/10072_2025_8000_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/257e6c92c9b5/10072_2025_8000_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cfb/12084249/c9bb2cb76a30/10072_2025_8000_Fig9_HTML.jpg

相似文献

[1]
Comparison of the efficacy of different protocols of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function, activities of daily living, and neurological function in patients with early stroke: a systematic review and network meta-analysis.

Neurol Sci. 2025-6

[2]
Comparative efficacy of different noninvasive brain stimulation protocols on upper-extremity motor function and activities of daily living after stroke: a systematic review and network meta-analysis.

Neurol Sci. 2024-8

[3]
Non-invasive Brain Stimulation Techniques for the Improvement of Upper Limb Motor Function and Performance in Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis.

Arch Phys Med Rehabil. 2023-10

[4]
Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis.

Front Neurol. 2022-6-15

[5]
Efficacy of coupling intermittent theta-burst stimulation and 1 Hz repetitive transcranial magnetic stimulation to enhance upper limb motor recovery in subacute stroke patients: A randomized controlled trial.

Restor Neurol Neurosci. 2020

[6]
Examining the effectiveness of motor imagery combined with non-invasive brain stimulation for upper limb recovery in stroke patients: a systematic review and meta-analysis of randomized clinical trials.

J Neuroeng Rehabil. 2024-11-30

[7]
Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke.

Cochrane Database Syst Rev. 2020-11-11

[8]
Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis.

J Neuroeng Rehabil. 2024-10-16

[9]
Dual-mode noninvasive brain stimulation over the bilateral primary motor cortices in stroke patients.

Restor Neurol Neurosci. 2017

[10]
The effect and optimal parameters of repetitive transcranial magnetic stimulation on lower extremity motor function in stroke patient: a systematic review and meta-analysis.

Disabil Rehabil. 2024-10

本文引用的文献

[1]
Theta burst stimulation: what role does it play in stroke rehabilitation? A systematic review of the existing evidence.

BMC Neurol. 2024-2-1

[2]
Clinical application of repetitive transcranial magnetic stimulation in improving functional impairments post-stroke: review of the current evidence and potential challenges.

Neurol Sci. 2024-4

[3]
Non-invasive brain stimulation for functional recovery in animal models of stroke: A systematic review.

Neurosci Biobehav Rev. 2024-1

[4]
Continuous Theta-Burst Stimulation of the Contralesional Primary Motor Cortex for Promotion of Upper Limb Recovery After Stroke: A Randomized Controlled Trial.

Stroke. 2023-8

[5]
Non-invasive Brain Stimulation Techniques for the Improvement of Upper Limb Motor Function and Performance in Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis.

Arch Phys Med Rehabil. 2023-10

[6]
From Molecule to Patient Rehabilitation: The Impact of Transcranial Direct Current Stimulation and Magnetic Stimulation on Stroke-A Narrative Review.

Neural Plast. 2023

[7]
Repetitive Transcranial Magnetic Stimulation and Rehabilitation Therapy for Upper Limb Hemiparesis in Stroke Patients: A Narrative Review.

Prog Rehabil Med. 2023-3-1

[8]
Non-invasive brain stimulation for limb motor function and daily living activity improvement in acute stroke: A meta-analysis.

J Stroke Cerebrovasc Dis. 2023-4

[9]
Early transcranial direct current stimulation with modified constraint-induced movement therapy for motor and functional upper limb recovery in hospitalized patients with stroke: A randomized, multicentre, double-blind, clinical trial.

Brain Stimul. 2023

[10]
Effects and safety of high-frequency rTMS in acute intracerebral hemorrhage patients: A pilot study.

J Neurol Sci. 2022-12-15

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